Psychosocial aspects and support networks associated with disability in two longevous populations in Brazil: a cross-sectional study.

BACKGROUND: Among the oldest old, aged 80 years and over, the prevalence of disability is higher than in other age groups and can be considered a predictor of mortality. OBJECTIVE: To evaluate how psychosocial aspects and support networks influence the disability of these oldest-old individuals, performing a comparison between two longevous populations, one living in one of the poorest regions of Brazil, in the backlands of Paraíba, and another living in one of the largest urban centres in Latin America. METHOD: A cross-sectional study in which 417 oldest-old persons aged 80 years and older were interviewed, with data collected through the "Health, Welfare and Ageing" survey conducted in two Brazilian cities. Disability was assessed by reporting the need for assistance in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Bivariate and multiple analyses were performed using R statistical software. RESULTS: Food insufficiency in the first years of life had negative repercussions on the disability of oldest old people living in the northeast. On the other hand, in this region, older people have a higher rate of support and live longer with their peers, which may contribute to reducing feelings of loneliness, depressive symptoms, and worse self-perception of health. In the Southeast, financial constraints, subjective poverty, and unmet needs may favour the development of functional limitations between long-lived people. CONCLUSION: Our findings indicate that regional differences in Brazil may influence the disability of older people aged 80 and older. In northeast Brazil, having no partner may contribute to disability for ADLs and IADLs; while, in the longevous population of São Paulo, having a worse self-rated health may contribute to disability for IADLs.

Regional differences regarding the occurrence of falls and associated factors in two populations of Brazilian longevous people.

BACKGROUND: Few studies have explored regional asymmetries and their implications for health policies regarding episodes of falls among the population of ≥80 years old in continental and developing countries like Brazil with deep inequalities and sociocultural differences. OBJECTIVE: To evaluate the occurrence of falls and their association with functional capacity and nutritional status in the longest oldest-old living in two municipalities in the Northeast and Southeast of Brazil. METHODS: This is a cross-sectional study, with primary data collection in which were included in the research seniors aged 80 years or more, of both sexes, belonging to two Brazilian municipalities of discrepant socioeconomic aspects. The dependent variable was the occurrence of falls in the last year. The independent variables were grouped into demographic aspects, functional capacity and nutritional status. To identify variables that contribute to the occurrence of falls, the multiple logistic regression model, adopts a significance level of 5%. RESULTS: The sample was composed of 415 oldest-old adults. From the total, 32.3% reported having fallen in the last year, 24.7% in Brejo dos Santos and 37.8% in São Paulo. Among the former population, the mean value of walking speed for those who had falls was 0.27 m/s and for those who had no occurrence of falls was 0.33 m/s; and, among the seniors from São Paulo, the mean values were 0.51 m/s and 0.58 m/s, respectively. Significant correlations between walking speed and falls were verified for both populations, showing that the lower the walking speed, the higher the predisposition to falls. In the final regression model, the occurrence of falls was associated with moderate balance (OR = 5.28; CI: 1.11-25.18) among the longevous people Brejo dos Santos and with very poor functional performance (OR = 16.09; CI:1.46-177.06) among those from São Paulo. CONCLUSION: The results pointed out a lower prevalence of falls in longevous people from Brejo dos Santos than in those from São Paulo and differences regarding the associated factors, showing heterogeneity between the two populations; indicating the need for public policies and effective programmes aimed at preventing falls based on the maintenance or increase of functional capacity.

Socioeconomic Factors and Health Status Disparities Associated with Difficulty in ADLs and IADLs among Long-Lived Populations in Brazil: A Cross-Sectional Study.

OBJECTIVE: To evaluate the association between socioeconomic factors, health status, and Functional Capacity (FC) in the oldest senior citizens in a metropolis and a poor rural region of Brazil. METHOD: Cross-sectional study of 417 seniors aged ≥80 years, data collected through Brazil's Health, Well-being and Aging survey. FC assessed by self-reporting of difficulties in Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Chi-square tests and multiple logistic regression analyses were performed using "R" statistical software. RESULTS: Socioeconomic and demographic inequalities in Brazil can influence FC in seniors aged 80 years and older. Comparatively, urban long-lived people had a higher prevalence of difficulties for ADLs and rural ones showed more difficulties for IADLs. Among urban oldest seniors, female gender and lower-income were correlated with difficulties for IADLs. Among rural oldest seniors, female gender, stroke, joint disease, and inadequate weight independently were correlated with difficulties for ADLs, while the number of chronic diseases was associated with difficulties for IADLs. CONCLUSION: Financial constraints may favor the development of functional limitations among older seniors in large urban centers. In poor rural areas, inadequate nutritional status and chronic diseases may increase their susceptibility to functional decline.

O e-sus atenção básica e a coleta de dados simplificada: relatos da implementação em uma estratégia saúde da família / E-SUS primary care and simplified data collection: reports on implementation in a family health strategy setting

Este estudo tem como objetivo relatar os problemas e as facilidades vivenciadas pelos profissionais da estratégia saúde da família na implementação do E-SUS Atenção Básica. Trata-se de um relato de experiência acerca da utilização das fichas de Coleta de Dados Simplificada, descrito sob a perspectiva de enfermeiras. Observaram-se como problemas: insegurança com a utilização das novas fichas, a falta de orientação para o preenchimento adequado, dificuldades em atender aos usuários por meio do cartão do SUS e como facilidades foram observadas a redução da quantidade de dados a serem coletados e a integração das informações. Com isso, considera-se que o novo sistema trouxe importantes mudanças para o processo de trabalho da Estratégia Saúde da Família, principalmente, no que se refere à diminuição da sobrecarga de trabalho burocrático para o enfermeiro; porém, esse novo processo de coleta de dados ainda precisa ser mais bem ajustado à realidade local e, para isso, se faz necessário que os profissionais sejam escutados pela gestão, expondo suas opiniões e ideias, para que, assim, se consiga chegar ao ideal, trabalhando em equipe.

This study's purpose was to describe the problems and advantages experienced by professionals in the family health strategy in the implementation of E-SUS (Unified Health System) Primary Care. This is an experience report on the use of the Simplified Data Collection forms, described from the perspective of nurses. Observed problems included: uncertainties about the use of the new forms, lack of guidance for their proper completion, difficulties in attending users via the SUS card. Advantages included: reduced amount of data to be collected, integration of information, etc. Thus, it is judged that the new system has brought major changes to the Family Health Strategy work process, particularly in reducing the bureaucratic workload for nurses. However, this new data collection process still needs to be better adjusted to local conditions, and toward this end professionals need to be heard by management, expressing their opinions and ideas, in order to reach the ideal, working as a team.